Information
Enables patients with complex palliative symptoms to remain at home (or be discharged home) who would otherwise require admission/extension of admission to acute hospital or hospice
- 5 ‘virtual hospice beds’ in South Edinburgh, Midlothian and West Lothian
- Supports patients with complex palliative care needs to remain in their own home, care home or nursing home.
- Face to face daily assessment and management by senior doctor and registered nurse
- Telephone support and remote consultations also available
- The team have the ability to visit any time of day (9am-8pm) and our Rapid Response (Marie Curie Lothian Nursing Service) team can visit at night (9pm to 9am).
- Work collaboratively with GP/DNs, although GP remains primary clinician
- Administration of subcutaneous medications and continuous infusions via syringe driver
- Practical nursing care e.g. urinary catheterisation, wound dressings
- Not a substitute for social care packages
- One year pilot, funded by Scottish government
All referrals are managed by the Single Point of Access team which is the route of access for all clinical services.
Who can refer:
Any healthcare professional can refer although we request that the patient’s own GP is aware of the referral
Who to refer:
Patients (over 16 years, their families, and informal carers) with complex problems associated with active advanced and progressive illness, irrespective of underlying diagnosis.
‘Complex problems’ are defined as those which are severe and unable to be managed by current care team or setting. Please consider early contact with the team if you have any questions regarding referral.
Who not to refer:
People who do not have specialist palliative care needs
People who do not have a life limiting illness.
Please Contact SPOA for advice if unsure.
How to refer:
Referrals accepted via SCI Gateway (TBA) or can be sent on a hospice referral form and emailed to: ci.mche.admin@nhs.scot
You can also phone the Single Point of Access Team: 0131 470 2253
A phone call is often helpful to highlight urgent needs and to provide background.
The team is available Mon- Friday 9am-5pm (except Bank Holidays).
All new referrals are responded to within 7 working days; urgent referrals within 2 working days – Calls for patients already known are responded to by the SPOA Team on the same day or can be scheduled for contact by community team that know them the next day.
For professional advice on patients known Marie Curie or within the Hospice catchment area:
Monday-Friday 08.30 to 16.30 (Except bank holidays), please phone the Single Point of Access Team on 0131 470 2253
For professional advice out with the above hours, please contact the 1st on call palliative care doctor who can be accessed via hospital switchboard on 0131 536 1000
For syringe driver medicines compatibilities please check Syringe pump / driver compatibles | Right Decisions initially.
Advice on compatibilities not listed in Right Decisions can be obtained by contacting the hospice Single Point of Access Team.
Further links to useful clinical information can be found in the Resources Tab on this page
Marie Curie Community Specialist Palliative Care Team support – Frequently asked questions
“Can hospice clinicians not prescribe medications?”
At present there are still no options available to independent hospice physicians or nurse prescribers to write scripts in Lothian other than via private prescriptions, which patients would need to pay for. This is not a decision taken by Marie Curie and we recognise the difficulties the current system can present for GPs including:
-Requests for urgent scripts during busy clinics.
-Requests for complex medications and doses that may be unfamiliar.
-The potential for error through written or verbal communication of requests.
We are incredibly grateful for the work done by our GP colleagues to provide prescriptions under the current system. Until there is a change in health board policy on this matter, we will continue to do our best to communicate the need for prescriptions in a timely, accurate and concise manner.
“Can you prescribe Oxygen in the community?”
Our Hospice senior doctors can prescribe oxygen via Dolby Vivisol Scotland.
If oxygen is needed urgently or next working day, then please phone the hospice Access team to discuss this. Otherwise, oxygen delivery may take up to 1 week as standard.
For a prescription we require the following information in an e-mail or discussed via the phone:
- Patient’s Name, CHI, Address and contacts number (and a second contact number if possible)
- Indication for oxygen
- Current flow rate of oxygen and predicted maximum flow rate in Litres/min
- Need for any additional equipment: Nasal cannula, non-breathable masks, extra-long tubing
- Need for any ambulatory equipment: Please tell us the flow rate needed and the maximum duration in 24hours the person will require to use this.
- There can be no smokers in the house and the patient must not be using a vape
- Urgency: Same day (8 hours), next working day or 4 working days.
“Can you complete MCCD (death certificates) in the community?”
Only our Enhanced Hospice at Home team doctors can complete an online MCCD for community patients
We recognise that the Enhanced Hospice at Home team may be best placed to complete the MCCD in many circumstances as they have daily contact in the last days-weeks of the patient’s life. If the patient dies under the support of our Enhanced Hospice at Home team, one of the team’s doctors will contact the practice to discuss this and plan for who is completing the form
